| NPI | 1356796767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00873000) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00873000) |
| 363A00000X Physician Assistant (Licence: PA MA058463) | |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2025-09-11 |